Quality of life and mental health in the bereaved family members of patients with terminal cancer.

OBJECTIVE: This study specifically aimed to compare quality of life (QOL) and mental health in bereaved family members of patients with cancer with that of the general population and to examine factors associated with QOL and mental health in this population. DESIGN: A nationwide multicenter, cross-sectional survey was administered to the bereaved family members of patients with terminal cancer. SETTING: Thirty-three palliative care centers designated by the Ministry of Health and Welfare participated in this study. PARTICIPANTS: The participants in this study were 501 bereaved family members of patients with terminal cancer and matched control individuals from the Korean National Health and Nutrition Examination Survey. MEASUREMENT: EQ-5D and several questions used in Korean National Health And Nutrition Examination Survey were used in to measure health-related QOL and mental health. RESULTS: Health-related QOL, as determined by EQ-5D, was significantly lower in bereaved family members than in controls (0.88 ± 0.20 vs 0.93 ± 0.13, p = 0.002). Bereaved family members experienced more frequent episodes of depression (33.1% vs 12.5%, p < 0.001) and suicidal thoughts (31.4% vs 16.4%, p < 0.001) during the previous year than did controls. Female sex, lower income, spousal relationship, and longer duration of survival after palliative care referral were negatively correlated with health-related QOL. Younger age and higher mental burden of caregiving were associated with a higher risk of impaired mental health. DISCUSSION: Our results confirm that bereaved family members of patients with cancer have lower health-related QOL and mental health than the general population. Healthcare providers should focus more attention on this vulnerable group, and various support programs should be developed to improve their health-related QOL.

Quality of life and mental health in family caregivers of patients with terminal cancer.

PURPOSE: The burden of serving as a caregiver is known to impair quality of life (QOL) and mental health caregivers of cancer patients. However, few studies focused on the caregivers of terminal cancer patients. Furthermore, none has compared them with those of general population. METHODS: We surveyed the family caregivers of terminal cancer patients who received palliative care services in Korea. Control individuals were selected from participants in the first round of the fourth Korea National Health and Nutrition Examination Survey and were matched with family caregivers using the propensity score method to optimize our comparative analysis. RESULTS: Health-related QOL was significantly lower in the caregiver group than in the controls. Caregivers experienced more frequent episodes of depression during the previous year than did controls (36.3% vs. 12.4%, P < 0.0001). Caregiver burden, such as "impact on health," "financial problems," and "lack of family support" had a negative influence on the health-related QOL and mental health. However, "disrupted schedule" had a positive influence on the QOL and mental health. DISCUSSION: Our results show that the family caregivers of patients with terminal cancer experience mental health problems and deterioration of health-related QOL. Culturally appropriate caregiver support programs are needed to decrease the impact of caregiving on the QOL and mental health of family caregivers in Korea.

Green tea consumption and risk of stomach cancer: a meta-analysis of epidemiologic studies.

This meta-analysis investigated the quantitative association between the consumption of green tea and the risk of stomach cancer in epidemiologic studies using crude data and adjusted data. We searched MEDLINE, EMBASE and the Cochrane Review in August 2007. All the articles searched were independently reviewed and selected by 3 evaluators according to predetermined criteria. A total of 13 epidemiologic studies were included. When all the case-control and cohort studies were pooled, the odds ratios (OR) [corrected] of stomach cancer for the highest level of green tea consumption when compared with the lowest level of consumption were shown to be 1.10 (95% confidence interval (CI), 0.92-1.32) using the crude data and 0.82 (95% CI, 0.70-0.96) using the adjusted data.In the meta-analyses of case-control studies, no significant association was seen between green tea consumption and stomach cancer using the crude data (odds ratio (OR), 0.79; 95% CI, 0.58-1.07) [corrected], but green tea was shown to have a preventive effect on stomach cancer using the adjusted data (OR, 0.73; 95% CI, 0.64-0.83) [corrected]. In the meta-analyses of the recent cohort studies, the highest green tea consumption was shown to significantly increase stomach cancer risk using the crude data (RR, 1.59; 95% CI, 1.16-2.18), but no significant association between them was seen when using the adjusted data (RR, 1.04; 95% CI, 0.93-1.17). Unlike the case-control studies, no preventive effect on stomach cancer was seen for the highest green tea consumption in the meta-analysis of the recent cohort studies. Further clinical trials are needed.